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September 1966

Cordotomy for Intractable Pain of Nonmalignant Origin: Review of Twenty Cases

Author Affiliations

From the Department of Surgery, Division of Neurological Surgery, Indiana University School of Medicine, Indianapolis.

Arch Surg. 1966;93(3):480-486. doi:10.1001/archsurg.1966.01330030110022

ATEROLATERAL spinal tractotomy, or cordotomy, was introduced in 1911 by Spiller and Martin. General acceptance followed the report of Frazier in 1920. It continues to be an effective procedure for the alleviation of pain associated with malignant disease.1,2

In the past half century, this procedure has also been performed, but less frequently, for a variety of painful states of nonmalignant origin,3-15 most commonly in paraplegia, tabes dorsalis, sciatica or arachnitis, amputation stump pain, and phantom limb pain.16 In addition, this operation has been performed for pain in a number of other benign disease entities, such as interstitial cystitis, acute porphyuria, osteoarthritis, postherpetic neuralgia, painful scar, peripheral vascular disease, and kraurosis vulvae.7,8,10,13,16-30

Nearly 70% of the cordotomies reported in approximately 150 cases of painful paraplegia (Table 1) have been of benefit. Whether or not the burning pain sometimes associated with this paralytic state could consistently be relieved

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